Meta-Analysis of the Effectiveness and Safety of Intravenous Thrombolysis in Patients with Acute Cerebral Infarction

Effects of butylphthalide on cerebral vascular circulation, coagulation function, and neurological function in patients with acute severe ischemic stroke following intravenous thrombolysis: a preliminary study

OBJECTIVE

To analyze the effects of Butylphthalide on cerebral vascular circulation, coagulation function, and neurological function in patients with acute severe ischemic stroke following intravenous thrombolysis.

METHODS

Clinical efficacy, cerebral vascular circulation indicators [anterior cerebral artery (ACA), middle cerebral artery (MCA), vertebral artery (VA) blood flow velocity], coagulation function indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB)], neurological function indicators [Activities of Daily Living (ADL) score.

RESULTS

The total effective rate of treatment in the control group was 76.47%, while in the observation group, it was 96.08%, with the observation group showing a significantly higher total effective rate than the control group (p < 0.05). Before treatment, there was no significant difference in ACA, MCA, and VA blood flow velocity between the two groups (p > 0.05). However, after treatment, the ACA, MCA, and VA blood flow velocity in the observation group were significantly higher than those in the control group (p < 0.05). Before treatment, there was no significant difference in PT, APTT, TT, and FIB levels between the two groups (p > 0.05).

CONCLUSION

In patients with acute severe ischemic stroke undergoing intravenous thrombolysis, the addition of Butylphthalide to the treatment regimen yields favorable clinical outcomes. Compared to Alteplase alone, the addition of Butylphthalide further improves cerebral vascular circulation and coagulation function, promoting the recovery and reconstruction of neurological function in patients. Importantly, the addition of Butylphthalide does not increase the risk of adverse reactions, making it a safe and ideal option for clinical application.

Efficacy of butylphthalein injection combined with alteplase thrombolysis in patients with acute cerebral infarction and its impact on Lp-PLA2 and CXCL16 levels

OBJECTIVE

To evaluate the efficacy of butylphthalein injection combined with alteplase thrombolysis in patients with acute cerebral infarction (ACI) and its effects on lipoprotein-associated phospholipase A2 (Lp-PLA2) and CXC chemokine ligand 16 (CXCL16) levels.

METHODS

A total of 127 ACI patients admitted to Shandong Provincial Third Hospital between March 2020 and June 2023 were included and divided into a butylphthalein group (n = 67) and a control group (n = 60) based on their treatment regimen. All patients received basic treatment. Additionally, the control group underwent intravenous thrombolysis with alteplase, while the butylphthalein group received butylphthalein injection combined with alteplase thrombolysis. Both groups were treated for two consecutive weeks.

RESULTS

The overall clinical efficacy rate in the butylphthalein group was significantly higher than that in the control group (P < 0.05). After treatment, cerebral infarction size and National Institutes of Health Stroke Scale (NIHSS) scores were significantly reduced in both groups (both P < 0.05), with greater reductions observed in the butylphthalein group (both P < 0.05). The peak systolic velocity (Vs) of the posterior cerebral, vertebral, and basilar arteries increased significantly in both groups after treatment compared with baseline (all P < 0.05), with higher values in the butylphthalein group (all P < 0.05). The resistance index (RI) of these arteries decreased significantly in both groups after treatment (P < 0.05) and was lower in the butylphthalein group than in the control group (P < 0.05). Serum levels of IL-6, TNF-α, CRP, Lp-PLA2, and CXCL16 were significantly lower after treatment in both groups (all P < 0.05), with greater reductions in the butylphthalein group (all P < 0.05). There was no significant difference in adverse effects between the two groups (P > 0.05).

CONCLUSION

The combination of butylphthalein injection and alteplase intravenous thrombolysis is effective in improving clinical outcomes, reducing neurological deficits, enhancing microcirculation, and lowering serum Lp-PLA2 and CXCL16 levels in patients with ACI. This therapy is worth clinical promotion.

A new machine learning model to predict the prognosis of cardiogenic brain infarction

Cardiogenic cerebral infarction (CCI) is a disease in which the blood supply to the blood vessels in the brain is insufficient due to atherosclerosis or stenosis of the coronary arteries in the patient's heart, which leads to neurological deficits. To predict the pathogenic factors of cardiogenic cerebral infarction, this paper proposes a machine learning based analytical prediction model. 494 patients with CCI who were hospitalized for the first time were consecutively included in the study between January 2017 and December 2021, and followed up every three months for one year after hospital discharge. Clinical, laboratory and imaging data were collected, and predictors associated with relapse and death in CCI patients at six months and one year after discharge were analyzed using univariate and multivariate logistic regression methods, meanwhile established a new machine learning model based on the enhanced moth-flame optimization (FTSAMFO) and the fuzzy K-nearest neighbor (FKNN), called BITSAMFO-FKNN, which is practiced on the dataset related to patients with CCI. Specifically, this paper proposes the spatial transformation strategy to increase the exploitation capability of moth-flame optimization (MFO) and combines it with the tree seed algorithm (TSA) to increase the search capability of MFO. In the benchmark function experiments FTSAMFO beat 5 classical algorithms and 5 recent variants. In the feature selection experiment, ten times ten-fold cross-validation trials showed that the BITSAMFO-FKNN model proved actual medical importance and efficacy, with an accuracy value of 96.61%, sensitivity value of 0.8947, MCC value of 0.9231, and F-Measure of 0.9444. The results of the trial showed that hemorrhagic conversion and lower LVDD/LVSD were independent risk factors for recurrence and death in patients with CCI. The established BITSAMFO-FKNN method is helpful for CCI prognosis and deserves further clinical validation.

The effect of stent retriever mechanical thrombectomy combined with tirofiban in treating acute ischemic stroke

OBJECTIVE

To analyze the effectiveness of stent retriever mechanical thrombectomy combined with tirofiban in treating acute ischemic stroke.

METHODS

Markedly effective is defined as an SIS score of over 90, effective is indicated by an SIS score of between 50-90, and a score of below 50 suggests ineffective treatment results.

RESULTS

①The treatment's overall effectiveness in the observation group (91.30%) was significantly higher than that in the control group (75.56%) (p < 0.05). ②The vascular recanalization rate in the observation group (89.13%) was significantly higher than that in the control group (71.11%) (p < 0.05). ③The stent retrieval operation count (2.41 ± 0.23) was significantly lower in the observation group than in the control group (1.29 ± 0.16) (p < 0.05). ④ After treatment, the platelet aggregation rate (10.74 ± 3.95) and NIHSS scores (6.58 ± 1.04) were significantly lower, and the Barthel index (77.86 ± 7.21) was significantly higher in the observation group compared to the control group (26.47 ± 5.12, 7.75 ± 2.36, 68.12 ± 6.15) (p < 0.05). All platelet aggregation rate, NIHSS scores and Barthel Index showed significant improvement after treatment when compared to those before treatment (p < 0.05).

CONCLUSION

The combined application of stent retriever mechanical thrombectomy and tirofiban in acute ischemic stroke treatment shows promising effectiveness. Compared to stent retriever alone, tirofiban adjunctive therapy enhances vascular recanalization, reduces retrieval procedures, shortens treatment duration, inhibits platelet aggregation, and improves neurological function recovery, daily living activities, and prognosis. Moreover, it doesn't significantly increase symptom-related risks.

Efficacy of urokinase and alteplase intravenous thrombolysis in the treatment of acute phase cerebral infarction and impact on serum S-100β and nerve growth factor levels

OBJECTIVE

To compare the efficacy of urokinase and alteplase intravenous thrombolysis in the treatment of acute phase cerebral infarction and investigate their impact on serum S-100β and nerve growth factor (NGF) levels.

METHODS

Parameters assessed included NIHSS score reduction, vascular recanalization rates, mRS, Barthel Index, and adverse reactions. Post-treatment blood samples were also collected for further analysis.

RESULTS

The clinical treatment effectiveness and Vascular recanalization rate in Group A was higher than in Group B, with p < 0.05. After treatment, the NIHSS score in Group A was lower than in Group B (p < 0.05), and the mRS score was slightly lower, but the difference was not significant (p > 0.05). After treatment, the levels of IL-6, TNF-α, and CRP in Group A were lower than in the control group (p < 0.05). The S-100β level in Group A was lower than in Group B, and NGF level was higher than in Group B (p < 0.05). Group A had better prognosis.

CONCLUSION

The efficacy and safety of both urokinase and alteplase intravenous thrombolysis for acute phase cerebral infarction have been demonstrated, yet disparities exist in neurological function recovery and regulation of biochemical indicators. Alteplase intravenous thrombolysis emerges as the superior option, displaying greater effectiveness and safety, alongside improved regulation of serum S-100β and NGF levels. Tailoring treatment plans to individual patient characteristics and drug mechanisms is essential. Given these findings, the promotion of alteplase intravenous thrombolysis in the management of acute phase cerebral infarction is justified.

Impacts of evidence-based nursing combined with enteral nutrition on nutritional status and quality of life in acute cerebral infarction patients: A randomized controlled trial

OBJECTIVE

To explore the impacts of evidence-based nursing (EBN) combined with enteral nutrition (EN) on nutritional status as well as quality of life in acute cerebral infarction (ACI) patients.

METHODS

In this randomized controlled cluster trial, 80 ACI patients admitted to our hospital from January 2021 to December 2022 were selected and randomly separated into study group (SG) and control group (CG), with 40 patients in each group. Patients in CG received routine nursing, and patients in the SG received EBN combined with EN. The neurological function, limb movement ability, nutritional status, anxiety and depression, incidence of complications and quality of life between two groups were compared.

RESULTS

After intervention, the NIHSS score in the SG was lower than that in the CG (CG = 5.62 ± 0.56, SG = 3.27 ± 0.33. p < .001). The FMA score in the SG was higher compared with the CG (CG = 52.58 ± 5.32, SG = 68.85 ± 6.87. p < .001). The Hb level, TP level and ALB level in the SG were higher relative to the CG (p < .001). The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores in the SG were lower in comparison with the CG (SAS score: CG = 42.32 ± 4.25, SG = 36.28 ± 3.64; SDS score: CG = 48.27 ± 4.85, SG = 40.06 ± 4.05. p < .001). The incidence of complications in SG was lower than that in CG. Finally, we found that SF-36 scores in the SG in all dimensions were higher than those in the CG (Physiological function: CG = 70.23 ± 7.05, SG = 82.71 ± 8.26. Role function: CG = 66.28 ± 6.64, SG73.39 ± 7.36. Physical pain: CG = 70.67 ± 7.06, SG = 82.69 ± 8.29. General health: CG = 58.74 ± 5.86, SG66.62 ± 6.65. Mental health: CG = 53.68 ± 5.37, SG = 62.39 ± 6.31. Energy: CG = 60.75 ± 6.08, SG = 67.87 ± 6.78. Social function: CG = 76.25 ± 7.25, SG = 85.78 ± 8.59. Emotional function: CG = 61.23 ± 6.15, SG = 75.74 ± 7.56. p < .001).

CONCLUSION

EBN combined with EN can improve the nutritional status and the quality of life in ACI patients compared with the traditional routine nursing, and is suggested as a valuable strategy for clinical management of ACI.

Retracted: Meta-Analysis of the Effectiveness and Safety of Intravenous Thrombolysis in Patients with Acute Cerebral Infarction

[This retracts the article DOI: 10.1155/2021/2833043.].

Intravenous Thrombolysis Combined with Arterial Thrombolysis (Bridging Therapy) Effectively Improves Vascular Recanalization Rate in Patients with Cerebral Infarction

Objective

To explore the efficacy of intravenous thrombolysis combined with arterial thrombolysis (bridging therapy) in patients with acute cerebral infarction and its effect on serum inflammatory factors.

Methods

The case data of 138 patients with acute cerebral infarction admitted to our hospital from February 2019 to February 2021 were retrospectively analyzed. According to the treatment plan they received, patients were assigned to two groups, namely, an observation group (n = 71) treated with bridging therapy and a control group (n = 67) treated with intravenous thrombolysis alone. The following indexes were recorded and compared between the two groups: treatment efficacy, National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living, incidence rates of vascular recanalization, intracranial hemorrhage and reembolization after treatment, levels of inflammatory factors before and after treatment, levels of prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) before and 1 week after treatment, and modified Rankin Scale scores 1, 3, and 6 months after treatment.

Results

Compared with the control group, the therapeutic efficacy, neurological function, activities of daily living, and vascular recanalization were markedly better in the observation group (P > 0.05). In addition, the incidence of intracranial hemorrhage and reembolization was statistically lower in the observation group (P < 0.05). No marked difference was found between the two groups in terms of pretreatment serum inflammatory factors and coagulation function (P > 0.05), while the above indicators improved statistically after treatment in both groups, with comparatively more obvious improvement in the observation group. It was also observed that, compared with the control group, the modified Rankin Scale score in the observation group was significantly better at 3 and 6 months after treatment (P < 0.05).

Conclusion

Bridging therapy can improve the vascular recanalization rate among patients suffering from acute cerebral infarction, reduce the incidence of intracranial hemorrhage and reembolization, and improve the prognosis and neurological function of patients, which is worthy of clinical application.